12 March 2012 11:56 AM

The answer to a difficult life is not murder

No one listening to the wife of Tony Nicklinson this morning on the 8.10am interview on Radio 4 could fail to be moved by her concern for her husband. Tony has "locked-in syndrome" following a stroke in 2005, which means he is totally paralysed and but mentally sound. He communicates through blinking, a technique that was made famous by Jean-Dominique Bauby, the French editor of ELLE magazine who similarly suffered a stroke at the age of 43 which left him only able to move his left eye-lid.

Tony Nicklinson has launched a legal action that would mean he could ask a doctor to end his life and the doctor would not be prosecuted for murder. He is trying to get an assurance that the rarely used 'common law defence of necessity' could be used by any doctor who took the action to end Tony's life. Tony doesn't want to die yet but if there comes a time when he thinks his life has become unbearable he wants to know that he can ask to be killed. This goes beyond the assisted suicide for which 'Dignitas' has become famous, as Tony is too disabled to take part in ending his own life through, e.g. drinking a lethal cocktail.

The problem is that what he is asking for is a fundamental change in the law on murder. It would set a precedent and 'He wanted me to end his life' would become a legitimate plea. This is one of those hard cases which if acted upon would leave us with not just a bad law, but a vulnerable population. Any severely disabled person would be at risk of someone declaring that they had wanted to die, especially those who find it difficult to communicate.

So what is to be done? Has Tony and others like him no choice but to be kept alive? I don't think that this is the case. As long as you have the mental capacity to make a decision, you have the legal right to refuse treatment. People like Tony are at high risk of infections, further strokes and other life threatening complications. He could simply say that he doesn't want to prolong his life, stop taking his pills (apart from the pain relief) and sign an 'advance decision', a legally binding document that sets out what treatment you do and don't consent to. 'Nature' could then take it's course.

The trouble is that we haven't had enough public discussion about medical intervention. Our ability to keep people alive has in many cases I think outpaced people's desire to live. Only this weekend I heard about further 'progress' in finding a pill that will allow us to live for another few decades. Have any of these researchers asked the public if that's what they want? I think the answer would be a resounding NO! We joke in health that dying is no longer an accepted outcome of treatment. However death is one of life's certainties and we seriously do need to have more debate and information about what our choices can be without introducing any new law that would introduce fear, uncertainty and legalise murder.

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JULIA MANNING

Julia studied visual science at City University and became a member of the College of Optometrists in 1991. Her career has included being a visiting lecturer in at City University, visiting clinician at the Royal Free Hospital, working with Primary Care Trusts and a Director of the UK Institute of Optometry. She also specialised in diabetes and founded Julia Manning Eyecare, a practice for people with mental and physical disabilities. In 2006 she established 2020health.org, an independent Think Tank for Health and Technology. Research publications have covered public health, telehealth, workability, pricing of medicines, biotechology, NHS reform and fraud.